Low and stable HIV infection rates in Senegal: natural course of the epidemic or evidence for success of prevention?

Méda, Nicolas; Ndoye, Ibra; Mboup, Souleymane; Wade, Abdoulaye; Ndiaye, Seynabou; Niang, Cheikh Ibrahima; Sarr, Fatoumata Diène; Diop, I; Caraël, Michel

doi:10.1097/00002030-199907300-00018

Cited by 116 publications

(70 citation statements)

References 18 publications

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“…30 However, data from the sentinel sites in southern Senegal (currently aVected by conflict) still showed an increasing trend in HIV prevalence. The population surveyed in this study have close links with the population of southern Senegal.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of herpes simplex type 2 and syphilis serology among young adults in a rural Gambian community

Shaw

2001

Sexually Transmitted Infections

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Objectives:To estimate prevalence and risk factors for herpes simplex 2 (HSV2) positivity, syphilis and Chlamydia trachomatis infection among rural people aged 15-34 in the Gambia. Methods: Questionnaires and serum samples were collected from 1076 men and women aged 15-34 during a cross sectional prevalence survey in a rural area of the Gambia. Sera were screened for antibodies to herpes simplex virus type 2 (HSV2), and for syphilis using Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin (RPR) tests. Urine was tested by polymerase chain reaction (PCR) for C trachomatis infection. Results: 28% of women and 5% of men were HSV2 ELISA positive; 10% of women and 2% of men were TPHA positive; and 7% of women and 1% of men were both RPR and TPHA positive.Out of 1030 urine sample tested only six were positive for C trachomatis. 7% of those who reported never having sex were positive for one or other of these tests. Prevalences of all STIs increased with age and were higher in women than men. Women were much less likely than men to seek treatment for STI symptoms at a health centre. Married people were at increased risk of an STI compared with single people. Jola and Fula women had a higher prevalence of HSV2 than women from other ethnic groups, and Fulas also had a higher prevalence of RPR/TPHA positivity. The limited number of sexual behaviour questions were not significantly associated with STIs after adjustment for age, marital status, and ethnic group. Conclusions: The prevalences of the ulcerative infections HSV2 and syphilis in this population are a cause for concern. In a setting where HIV1 prevalence remains low this indicates an urgent need for STI control and behaviour change programmes to prevent an HIV epidemic. Concerns about the validity of reported sexual behaviour data high light the necessity of biological markers in the evaluation of behaviour change programmes. (Sex Transm Inf 2001;77:358-365)

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Section: Discussionmentioning

confidence: 99%

Prevalence of herpes simplex type 2 and syphilis serology among young adults in a rural Gambian community

Shaw

2001

Sexually Transmitted Infections

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“…Senegal, where sex work is decriminalized and STI services are accessible to sex workers, has reported moderately low and stable STI prevalence. 32,33 In Nairobi, Kenya, targeted interventions with sex workers and improved STI case management in health centres preceded declines in ulcerative and other STIs and local disappearance of chancroid. 34,35 The scale of decline in STI rates in these examples is noteworthy.…”

Section: Measuring Sti Controlmentioning

confidence: 99%

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Steen¹,

Wi²,

Kamali³

et al. 2009

Bull World Health Org

116

103

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Control of sexually transmitted infections (STIs) is feasible, leads to improved sexual and reproductive health and contributes to preventing HIV transmission. The most advanced HIV epidemics have developed under conditions of poor STI control, particularly where ulcerative STIs were prevalent. Several countries that have successfully controlled STIs have documented stabilization or reversal of their HIV epidemics.STI control is a public health outcome measured by reduced incidence and prevalence. The means to achieve this include: (i) targeting and outreach to populations at greatest risk; (ii) promoting and providing condoms and other means of prevention; (iii) effective clinical interventions; (iv) an enabling environment; and (v) reliable data.Clinical services include STI case management, screening and management of STIs in sex partners. Syndromic case management is effective for most symptomatic curable STIs and screening strategies exist to detect some asymptomatic infections. Presumptive epidemiologic treatment of sex partners and sex workers complement efforts to interrupt transmission and reduce prevalence. Clinical services alone are insufficient for control since many people with STIs do not attend clinics. Outreach and peer education have been effectively used to reach such populations.STI control requires effective interventions with core populations whose rates of partner change are high enough to sustain transmission. Effective, appropriate targeting is thus necessary and often sufficient to reduce prevalence in the general population. Such efforts are most effective when combined with structural interventions to ensure an enabling environment for prevention. Reliable surveillance and related data are critical for designing and evaluating interventions and for assessing control efforts.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬ a

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“…Regular screening and treatment services for sex workers (22): [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90] in Senegal (where sex work is legal) have been credited with contributing to low and stable HIV seroprevalence. 55 A comprehensive approach to STI prevention and care was taken at Projet SIDA in Kinshasa, Zaire, where condom use and voluntary clinic attendance were promoted within networks of sex workers. 46 Regular screening for curable STIs was conducted using sensitive laboratory tests.…”

Section: Sex Worker Screening Programmesmentioning

confidence: 99%

Sexually Transmitted Infection Control with Sex Workers: Regular Screening and Presumptive Treatment Augment Efforts to Reduce Risk and Vulnerability

Steen

Dallabetta

2003

Reproductive Health Matters

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Low and stable HIV infection rates in Senegal: natural course of the epidemic or evidence for success of prevention?

Cited by 116 publications

References 18 publications

Prevalence of herpes simplex type 2 and syphilis serology among young adults in a rural Gambian community

Prevalence of herpes simplex type 2 and syphilis serology among young adults in a rural Gambian community

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Sexually Transmitted Infection Control with Sex Workers: Regular Screening and Presumptive Treatment Augment Efforts to Reduce Risk and Vulnerability

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